33D2091384 CLIA NUMBER - AMERICAN MEDICAL DIAGNOSTIC PLLC

Laboratory Demographics

  • CLIA Code: 33D2091384
  • Facility Name: AMERICAN MEDICAL DIAGNOSTIC PLLC
  • Facility Address: 1122 AVENUE P, 1ST FLOOR
    BROOKLYN, NY
    ZIP 11229
  • Facility Phone: 718 377-2834
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DR. EZRA C. ISRAEL
  • NPI Number: 1922436591
  • Taxonomy: 207RN0300X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 33D2091384
LAB Type Physician Office
Facility Name AMERICAN MEDICAL DIAGNOSTIC PLLC
Street 1122 AVENUE P, 1ST FLOOR
City BROOKLYN
State NY
ZIP 11229
Phone 718 377-2834
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/12/2025
Certificate Expiration Date 2/11/2027
Facility Type Physician Office
Lab Director DR. EZRA C. ISRAEL

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This page was last updated on: 9/29/2025